经括约肌间入路治疗马蹄形肛周脓肿的临床效果  

The Clinical Effect of Treating Horseshoe Shaped Perianal Abscess Through Intersphincteric Approach

作　　者：李龑杼 周福荣 陈晓娟 刘勇敢[1] LI Yanzhu;ZHOU Furong;CHEN Xiaojuan;LIU Yonggan(Zhongshan People's Hospital,Guangdong Zhongshan 528403)

机构地区：[1]中山市人民医院,广东中山528403

出　　处：《深圳中西医结合杂志》2024年第15期5-8,共4页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：中山市医学科研项目(2022J103)。

摘　　要：目的:分析经括约肌间入路治疗马蹄形肛周脓肿(PA)的临床效果及对肛门形态、功能和脓肿复发率的影响。方法:回顾性分析中山市人民医院2022年1月至2024年1月接受手术治疗的80例马蹄形PA患者,均接受脓肿切开引流术治疗,依据入路方案选择不同将患者分为对照组(40例,常规入路)和观察组(40例,经括约肌间入路+双侧括约肌间置管引流)。比较两组患者手术及预后相关指标、肛门形态、肛门功能及术后伤口愈合情况。结果:两组患者术中出血量比较,差异无统计学意义(P>0.05);相比于对照组,观察组患者手术时间较短、术后3 d疼痛评分较低,切口愈合时间及住院时间较短,差异具有统计学意义(P<0.05);相比于对照组,观察组患者肛门失禁发生率较低,差异具有统计学意义(P<0.05);在术后伤口良好愈合率上,较对照组,观察组均相对较高,差异具有统计学意义(P<0.05)。结论:马蹄形PA接受脓肿切开引流术治疗时,相比于常规入路来说,选择经括约肌间入路能够优化手术指标,缩短术后恢复时间,并保证术后肛门切口良好愈合,降低对肛门功能的影响。Objective To analyze the clinical efficacy of the inter-sphincteric approach in treating horseshoe perianal abscess(PA)and its impact on anus morphology,function,and recurrence rate.Methods A retrospective analysis was conducted on 80 patients with horseshoe PA who underwent surgical treatment at Zhongshan People’s Hospital from January 2022 to January 2024.All patients received abscess incision and drainage surgery.Based on the choice of approach,patients were divided into a control group(40 cases,conventional approach)and an observation group(40 cases,inter-sphincteric approach+bilateral inter-sphincteric tube drainage).The surgery and prognosis-related indicators,anus morphology,anus function,and postoperative wound healing were compared.Results There was no statistically significant difference in intraoperative blood loss between the two groups(P>0.05).Compared to the control group,the observation group had a shorter operation time,lower pain score on postoperative day 3,and shorter incision healing time and hospital stay,with statistically significant differences(P<0.05).The incidence of anal incontinence in the observation group was lower than that in the control group,with a statistically significant difference(P<0.05).The rate of good postoperative wound healing in the observation group was higher than that in the control group,with a statistically significant difference(P<0.05).Conclusion When treating horseshoe PA with abscess incision and drainage surgery,choosing the intersphincteric approach can optimize surgical indicators,shorten postoperative recovery time,ensure good healing of the anal incision,and reduce the impact on anal function compared to the conventional approach.

关 键 词：马蹄形肛周脓肿 经括约肌间入路 双侧括约肌间置管引流 

分 类 号：R657.1[医药卫生—外科学]